Pilot Study Focused on Knowledge, Attitudes, and Health Access Behaviors of Psychiatric-Mental Health Nurses Regarding Suicide Prevention.

OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.

Factors Associated With Staff Engagement in Patients' Tobacco Treatment in a State Psychiatric Facility.

BACKGROUND: Persons with mental illnesses (MI) who use tobacco are likely to experience poorer physical health and worsened psychiatric symptomology as compared to their non-tobacco-using counterparts. Therefore, engaging them in treatment is an important aspect of evidence-based care. OBJECTIVE: To use the theory of planned behavior to examine factors associated with intentions to provide and the provision of evidence-based tobacco treatment. DESIGN: This study is based on a cross-sectional analysis of survey data from 195 staff at a state psychiatric hospital. RESULTS: When controlling for demographic variables, attitudes, subjective norms, and perceived behavioral control toward providing tobacco treatment were associated with intentions to provide tobacco treatment, but only subjective norms and perceived behavioral control were associated with reported provision of evidence-based tobacco treatment. CONCLUSIONS: Understanding factors that influence provider delivery of tobacco treatment can better determine strategies to reduce the disproportionate tobacco use and related illnesses in behavioral health settings.

Evaluating the efficacy of graded in vivo exposure for the treatment of fear in patients with chronic back pain: a randomized controlled clinical trial.

Psychological treatments for chronic pain, particularly those based upon cognitive behavioural principles, have generally been shown to be efficacious. Recently, a treatment has been developed based upon the fear-avoidance model of chronic musculoskeletal pain, which suggests chronic pain can be relieved by exposing the individual to movements and tasks that have been avoided due to fear of (re)injury. This graded in vivo exposure treatment has been found to be beneficial in case studies. The present investigation utilized a randomized controlled trial method to assess the effectiveness of graded in vivo exposure relative to other conditions. Forty-four chronic low back pain patients were randomly assigned to graded in vivo exposure, graded activity, or a wait-list condition. While only trend differences were observed for pain-related disability, patients in the graded in vivo exposure condition demonstrated (a) significantly greater improvements on measures of fear of pain/movement, fear avoidance beliefs, pain-related anxiety, and pain self-efficacy when compared to those in the graded activity condition, and (b) significantly greater improvements on measures of fear-avoidance beliefs, fear of pain/movement, pain-related anxiety, pain catastrophising, pain experience, and anxiety and depression when compared to those in the wait-list control condition. Additionally, patients in the graded in vivo exposure condition maintained improvements in these areas at one month follow-up. Implications of these findings for the treatment of individuals with chronic low back and other pain conditions are discussed.